Idiopatyczny obrzek limfatyczny konczyn dolnych jest dośc rzadką chorobą o nieznanej etiologii. Wśrod
prawdopodobnych czynnikow wywolujących go wyroznia sie infekcje, predyspozycje genetyczne, malformacje
naczyn limfatycznych. Diagnoze potwierdza zwykle obserwacja kliniczna, jednak powinno sie ją zweryfikowac,
przeprowadzając limfoscyntygrafie. Rekomendowana przez Miedzynarodowe Towarzystwo Limfologiczne
terapia zwana kompleksową terapią przeciwzastoinową (CTD) obejmuje reczny drenaz limfatyczny, bandazowanie
uciskowe z zastosowaniem bandazy o malej elastyczności i cwiczenia przeciwzastoinowe. Kompleksowa
terapia przeciwzastoinowa daje dobre efekty terapeutyczne, potwierdzone badaniami klinicznymi. Jednak
w niektorych przypadkach niemozliwe jest osiągniecie jakiejkolwiek redukcji obrzeku lub uzyskany rezultat jest
niewielki. W obrzeku limfatycznym niepoddającym sie leczeniu za pomocą terapii kompresyjnej bezpieczną
i skuteczną metodą okazala sie liposukcja, wprowadzona do leczenia obrzeku przez Brorsona.
W ponizszym artykule przedstawiono przypadek obrzeku limfatycznego konczyny dolnej leczony za pomocą
liposukcji w ośrodku autorow pracy.
Acta Angiol 2011; 17, 4: 271–276
Background: There is a growing evidence of long-lasting lung changes after COVID-19. Our aim was to assess the degree of lung injury and evaluate the recovery process of 4–7-month-non-vaccinated convalescent patients discharged from hospital after moderate and severe COVID-19 pneumonia, who presented with symptoms of long-COVID. Methods: On control lung CT after mean 5-month recovery period, we classified and determined the prevalence of residual radiological abnormalities in 39 symptomatic patients. To assess the advancement of the persisting changes we used the total severity score (TSS) and the chest CT score and then correlated the results with clinical data. Results and conclusions: On follow-up CT images, 94.9% of patients showed persistent radiological abnormalities. The most frequent changes were ground-glass opacities (74.4%), reticular pattern (64.1%), fibrotic changes (53.8%), nodules (33.3%), bronchiectasis (15.4%), vascular enlargement (10.3%), and cavitation (5.1%). The median TSS score was 4.1 points (interquartile range 3), whereas the median of the chest CT score 5.4 points (interquartile range of 4.5). No significant differences were observed between sex subgroups and between the severe and moderate course groups. There were no association between both CT scores and the severity of the initial disease, indicating that, mean 5 months after the disease, pulmonary abnormalities reduced to a similar stage in both subgroups of severity.
Objective: The objective of this study was to evaluate the effect of intravascular low-level laser therapy (LLLT) on selected growth factor levels in subjects undergoing percutaneous coronary interventions (PCI). Background data: Restenosis remains the main problem with the long-term efficacy of PCI, and growth factors are postulated to play a crucial role in the restenosis cascade. Materials and methods: In a randomized prospective study, an 808 nm LLLT (100 mW/cm2, continuous wave laser, 9 J/cm2, illuminated area 1.6–2.5 cm2) was delivered intracoronarily to patients during PCI. Fifty-two patients underwent irradiation with laser light, and 49 constituted the control group. In all individuals, serum levels of insulin-like growth factor-1 (IGF-1), vascular endothelial growth factor (VEGF), transforming growth factor-β1 (TGF-β1), and fibroblast growth factor-2 (FGF-2) were measured before angioplasty, then 6 and 12 h and 1 month after the procedure. In all patients, a control angiography was performed 6 months later. Results: There were no significant differences in IGF-1 and VEGF levels between the groups. While evaluating FGF-2, we observed its significantly lower levels in the irradiated patients during each examination. There was a significant increase in TGF-β1 level in control group after 12 h of observation. In the irradiated individuals, control angiography revealed smaller late lumen loss and smaller late lumen loss index as compared with the control group. The restenosis rate was 15.0% in the treated group, and 32.4% in the control group, respectively. Conclusions: LLLT decreases levels of TGF-β1 and FGF-2 in patients undergoing coronary intervention, which may explain smaller neointima formation.
Choroby ukladu sercowo-naczyniowego są jedną z najczestszych przyczyn zgonow i dlugotrwalej niepelnosprawności.
Kwas acetylosalicylowy to bardzo skuteczny lek przeciwplytkowy, zmniejszający ryzyko zawalu
serca, udaru mozgu i zgonu o okolo 25% w grupie osob, u ktorych ryzyko sercowo-naczyniowe jest zwiekszone.
Wyniki badan klinicznych jednoznacznie wskazują na wysoką skutecznośc kwasu acetylosalicylowego
w profilaktyce pierwotnej i wtornej incydentow sercowo-naczyniowych, jednakze opornośc na ten związek
wynosi wedlug roznych szacunkow 5-45%. Opornośc na kwas acetylosalicylowy jest definiowana na podstawie
objawow klinicznych (incydent zakrzepowy podczas jego stosowania), jak rowniez za pomocą wielu wskaźnikow
wlaściwości agregacyjnych plytek. Male badania obserwacyjne wskazują na istnienie zwiekszonego
ryzyka sercowo-naczyniowego w subpopulacji osob, u ktorych wystepuje opornośc na kwas acetylosalicylowy.
Dotychczas nie poznano w pelni dokladnego mechanizmu oporności, a poza niepelną inhibicją cyklooksygenazy
i uwzglednia sie takze czas trwania terapii, wspolprace ze strony pacjenta, przyjmowanie rownocześnie
innych niesteroidowych lekow przeciwzapalnych. W pracy przedstawiono wszystkie znane mechanizmy prowadzące
do oporności na kwas acetylosalicylowy oraz konsekwencje kliniczne tego zjawiska. Zwrocono rowniez uwage na brak jednoznacznych kryteriow określających te opornośc, a takze zalecen wskazujących,
w jakim przypadku i kiedy nalezy przeprowadzic diagnostyke w tym kierunku.
The aim of the study was to assess the impact of regular professional sports activity on the endothelial and platelet function in young men. The studied group were 79 young men (18-40 y, 25 athletes and 54 without any regular physical activity). The nitric oxide (NO) metabolic pathway intermediates, oxidative stress markers, mediators of inflammation, and platelet aggregation were measured. Flow mediated dilation (FMD) was studied before and after intravenous 16,0 g L-arginine infusion, which was repeated after oral administration of acetylsalicylic acid (ASA-75 mg/day) for 4 days. Both groups had similar demographic characteristics. In the athletes, there was significantly higher hsCRP level, better serum lipid profile, and lower pulse pressure. Greater baseline FMD in athletes and in response to L-arginine disappeared following ASA treatment. There were no differences in the levels of the NO pathway metabolites. The control group was characterized by higher PAI-1 following ASA treatment and sICAM-1 both at baseline and after ASA, but no differences in MDA and 6-keto-PGF-1 alpha and platelet aggregation were noted. Regular professional physical activity modulates endothelial but not platelet function and may thus exert an effect on overall cardiovascular risk.
Objective: Regular physical activity may modulate cardiovascular risk due to its effect on endothelial and platelet function. The aim of this observational study was to assess the interplay between professional physical activity, endothelial and platelet function in young athletes. Design and method: The studied group constituted of n = 79 young men at age of 18–40 years (n = 25 were professional athletes and n = 54 men without any regular physical activity constituted control group). The levels of the nitric oxide (NO) metabolic pathway, oxidative stress markers (malonyldialdehyde-MDA, thiol index–GSH/GSSG), levels of sICAM-1, sVCAM-1, Serpin E1(PAI-1), sE-Selectin, sP-Selectin, VEGF, prostanoids (thromboxane B2(TXB2), 6-keto-PGF1-alpha) and platelet aggregation were measured. Flow-mediated-vasodilation (FMD) was studied before and after intravenous L-arginine (16.0 g) infusion, which was repeated after oral administration of acetylsalicylic acid (ASA-75 mg/day) for 4 days. Results: Both groups had similar demographic characteristics. There was a significantly higher CRP level, lower serum lipid profile and pulse pressure in the athletes group. Significantly greater FMD in athletes group at baseline as well as both, in response to L-arginine and following ASA treatment was observed. There were no differences in the levels of the NO pathway metabolites. The control group was characterized by lower thiol index and TXB2 levels and higher PAI-1 following ASA treatment and sICAM-1 both at baseline and after ASA, but no differences in MDA and 6-keto-PGF1-alfa levels and platelet aggregation were noted. Conclusions: The regular professional physical activity lowers the cardio-vascular risk through modification of inflammation, endothelial vasodilation and lipid profile. Lack of physical activity in young healthy men is associated with endothelial dysfunction. Endothelial dysfunction in physically non-active men results not from decreased nitric oxide synthesis, but its increased degradation. Professional physical activity does not significantly affect platelet function.
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